Provider Demographics
NPI:1437567732
Name:OTTO-BERGLUND, MORGAN (LCSW)
Entity Type:Individual
Prefix:MS
First Name:MORGAN
Middle Name:
Last Name:OTTO-BERGLUND
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2518 S 123RD ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68144-2777
Mailing Address - Country:US
Mailing Address - Phone:402-640-8282
Mailing Address - Fax:
Practice Address - Street 1:2723 S 87TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68124-3038
Practice Address - Country:US
Practice Address - Phone:402-640-8282
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-30
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA12591104100000X
MO20190402651041C0700X
NE22761041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker